This Phase 1 STTR application seeks support for research to enhance the commercial viability of a tool to assess the "cultural competence" of health care organizations. The tool was developed by Dr. Thomas A. LaVeist, who is director of the Hopkins Center for Health Disparities Solutions at the Johns Hopkins Bloomberg School of Public Health. The Cultural-competency Organizational Assessment - 360 (COA360) is a web-based tool to measure the cultural competence of healthcare organizations, and provides evidence-based interventions to help organizations improve. To date, the COA360 is the only cultural competency assessment tool to have undergone a rigorous validation study. The results of that study were published in the Journal of Healthcare Management (LaVeist et al. 2008). It is also the only cultural competency organizational assessment is administered online (COA360.ORG). A pilot test of the website has been completed and additional refinements have been made based on that test. The next step in establishing the technical/scientific merit and feasibility of the COA360 is to conduct simultaneous assessments on several hospitals, an evaluation of the experiences of the participants using the system, and a subsequent study of the effects of use of the COA360 process on improving the cultural competency of healthcare organizations. Specifically, this application seeks to address three specific aims for Phase I of the STTR Process: Specific Aim 1: to finalize the report format for the COA360. Specific Aim 2: to conduct a systematic evaluation of the user experience using the COA360. Specific Aim 3: to conduct a systematic evaluation of the efficacy of the COA360 report content and format. In Phase 2 of STTR funding, the aims will be to: (1) develop an intervention website for the COA360 system. This will involve the development of a web-based tool to deliver evidence-based interventions to help healthcare organizations improve their ability to meet the needs of the increasingly diverse U.S. population;(2) enroll a set of healthcare units into a study to determine if exposure to the intervention can improve cultural competency;(3) make additional enhancements to the system including (translating the COA360 into other languages, incorporate enhanced online help into the web-based system, and write a manual for the hospital point of contact. PUBLIC HEALTH RELEVANCE: The COA360 (Cultural-competency Organizational Assessment - 360) is a web-based tool to measure the cultural competence of healthcare organizations, and provides evidence-based interventions to help organizations improve. It is the only assessment tool to have undergone a rigorous validation study, and the only cultural competency organizational assessment administered online (COA360.ORG). Improving the cultural competence of a healthcare organization will lessen miscommunication between patients and healthcare providers, and increase provider sensitivity to the values, beliefs and health-related practices of the clients. This would increase the cultural relevance and acceptability of health educational messages, improve the accuracy of diagnoses and interventions, and improve adherence. The result should be improved patient satisfaction, better health outcomes, and a narrowing of gaps in disparities in health status and quality of care among racial/ethnic, religious and linguistic groups. We propose to conduct simultaneous assessments on several hospitals and to conduct an evaluation of the experiences of the participants using the system, and conduct a study of the effects of use of the COA360 process on improving the cultural competency of healthcare organizations.